Can You Get Pregnant With an IUD?

While rare, it is possible

You can get pregnant with an intrauterine device (IUD), but it's rare. IUDs are small, flexible devices shaped like the letter T that can be inserted into a person’s uterus by a healthcare provider. They can be hormonal or non-hormonal. IUDs are one of the most effective reversible methods of birth control available.

This article will go over how pregnancy with an IUD can happen. It will also discuss what to do if you think you might be pregnant even though you have an IUD.

Intrauterine device
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What to Do If You Suspect Pregnancy With an IUD

According to a 2018 research reviewunintended pregnancy rates in the first year after IUD insertion are 0.8% for the non-hormonal IUDs and 0.2% for the hormonal IUDs.

It is not uncommon for people with an IUD to assume incorrectly they are pregnant. People may have some irregular bleeding following IUD insertion, and others will stop having their periods altogether. If in doubt, take a pregnancy test.

If you think that you have conceived while using an IUD, there are three steps you should immediately take:

  1. Do a pregnancy test. You can take a home pregnancy test or schedule a blood pregnancy test with your healthcare provider.
  2. See a provider. Getting pregnant while using an IUD increases your risk of an ectopic pregnancy—a serious condition where the egg implants outside of the uterus. You need to see your provider or an obstetrician as soon as possible.
  3. Find out if you need to have your IUD removed. If you have a viable, non-ectopic pregnancy while your IUD is in place, your provider will likely recommend the removal of your IUD. Never try to remove an IUD on your own. Doing so can be dangerous whether you’re pregnant or not. 

What Happens If an IUD Moves Out of Place?

Sometimes, an IUD can move out of place in the uterus. It might get stuck in the wall of the uterus or even come out. If you think your IUD has started to come out, you can’t feel the strings or they feel shorter or longer than normal, call your provider. If you have intense pain and bleeding, seek immediate medical attention. 

Potential Risks of Pregnancy With an IUD

While you're not likely to get pregnant with an IUD, the highest risk is in the first year following IUD insertion. If the IUD wholly or partially falls out of the uterus (expulsion), it increases the risk of pregnancy. IUD expulsion happens in about 2% to 10% of cases.

If you do get pregnant with an IUD in place, there are several reasons why providers recommend IUD removal, including an increased risk of miscarriage, infection, and preterm delivery. Removing the IUD significantly reduces the risk of complications but does not eliminate them.

Miscarriage

People who become pregnant with an IUD are more likely to miscarry. Studies have shown that people who decide to leave the IUD in place after conception have a 40% to 50% greater risk of a miscarriage than people who have the devices removed.

Removing the IUD early in pregnancy appears to reduce the risk of miscarriage. However, the overall risk of miscarriage is still higher if you get pregnant with an IUD than it is in people who get pregnant without an IUD.

Preterm Birth

In addition to miscarriage, leaving an IUD in place during pregnancy increases the likelihood of preterm birth. Some studies suggest that having an IUD while you’re pregnant increases the risk of preterm birth by up to five-fold compared to when the IUD is removed.

Studies have shown that removing an IUD after conception reduces the rate of miscarriage from 54% to 20% and preterm delivery from 18% to 4%.

Infection

There is always a possibility of an infection called chorioamnionitis in people who have IUDs.  Chorioamnionitis is a condition of the placental membranes and the amniotic fluid that surrounds the fetus. It is severe and potentially life-threatening.

Taking your IUD out decreases the risk of chorioamnionitis—however, there is still some risk.

Placental Abruption

There may also be a link between becoming pregnant with an IUD and developing a complication where the placenta separates from the uterus either before or during delivery (placental abruption).

This complication can lead to significant blood loss, pregnancy loss, and, in some cases, death of the pregnant person.

Hormone Exposure

Of the five IUDs approved for use in the United States, only one is non-hormonal (Paragard). The other four are hormonal:

If you get pregnant with a hormonal IUD in place, the device will continue to deliver the hormone progestin to your uterus. The effect of the exposure on the fetus has not been established, but animal studies have suggested that it could increase the risk of congenital abnormalities.

Symptoms of Pregnancy

While it’s uncommon, it’s possible to get pregnant while you have an IUD. If an IUD has come out, you will no longer be protected against pregnancy. 

If you have signs and symptoms of pregnancy, talk to your provider. Common pregnancy symptoms include:

  • A missed or late period
  • Breast tenderness
  • Nausea and vomiting (“morning sickness” though it can be felt at any time of the day)
  • Headaches
  • Fatigue
  • Cramps
  • Light spotting 
  • Weight gain 

Summary

An IUD is a reliable form of birth control, but there can be problems with the devices that mean you’re at risk of becoming pregnant. 

If you think your IUD has moved or has come out, talk to your provider. They can find out if the IUD is still in place. You may need to use a backup form of birth control until you’re sure that the IUD is still effective.

If you have intense cramps and vaginal bleeding and can’t feel the strings of your IUD or they feel different than they normally do, these can be a sign of a more serious problem where the IUD goes through the wall of your uterus. Seek emergency medical care. 

Frequently Asked Questions

  • Can a pregnancy with an IUD survive?

    It is possible to have a healthy baby conceived with an IUD. However, there is an increased risk of ectopic pregnancy after IUD placement. An ectopic pregnancy is not viable and can be a medical emergency.

    If you get pregnant after inserting an IUD, contact your obstetrician immediately.

  • How do you know if you are pregnant after having an IUD?

    A pregnancy test is the only way to know if you are pregnant. After getting an IUD, many women stop getting periods after a few months.

    Hormonal IUDs can also sometimes cause side effects that mimic pregnancy symptoms.

  • What happens if you get pregnant with an IUD?

    If you get pregnant with an IUD, call your doctor right away. There is a risk of ectopic pregnancy with an IUD, which can become a medical emergency.

    If you get pregnant with an IUD and choose to carry the baby to term, your doctor will likely want to remove the IUD. You should never remove an IUD on your own.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. American College of Obstetricians and Gynecologists. Long-acting reversible contraception: intrauterine device and implant.

  3. UW Medicine. IUD perforation is rare, but women should still know about it.

  4. Jatlaoui TC, Halley E.M. Riley, Curtis KM. The safety of intrauterine devices among young women: a systematic review. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006

  5. A. Seval Ozgu-Erdinc, Ufuk Goker Tasdemir, Dilek Uygur, et al. Outcome of intrauterine pregnancies with intrauterine device in place and effects of device location on prognosis. 2014;89(5):426-430. doi:10.1016/j.contraception.2014.01.002

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  7. National Institute of Child Health and Human Development. What are some common signs of pregnancy?.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.